COPENHAGEN — Women with the highest level of cardiovascular disease risk also faced a sharply increased risk for osteoarthritis, in a study of nearly 9,000 women who were followed for 30 years.
Data collected in men showed a similar but less dramatic relationship.
“Our study, for the first time, provides evidence that cardiovascular disease risk factors are associated with an increased risk for osteoarthritis,” Dr. Umesh T. Kadam said at the annual European Congress of Rheumatology. “The role of cholesterol and body mass index [in this relationship] needs to be fully investigated,” added Dr. Kadam, an epidemiologist in the Arthritis Research Campaign National Primary Care Centre at Keele (England) University.
Prior findings from a variety of researchers showed that cardiovascular disease (CVD) and osteoarthritis (OA) often coexist in patients, and it's been hypothesized that vascular disease could play a pathogenic role in OA, acting in part via lipid metabolic pathways.
To further assess these relationships, Dr. Kadam and his associates used data collected from patients enrolled in the Malmö Preventive Project. The study enrolled a population-based cohort in the 1970s and assessed participants for a range of CVD risks. In the current analysis, knee or hip arthroplasty procedures were surrogates for the development of OA, after patients who had a fracture were excluded. Records on these procedures came from Swedish hospital registries for 8,749 women and 14,821 men from the Malmö cohort.
CVD risk was stratified based on several factors, including age, sex, social class, family CVD history, obesity, smoking status, serum glucose and cholesterol levels, blood pressure, body mass index, and diabetes. During 30 years of follow-up, about 1,000 of the participants had an OA-related procedure.
After the women were stratified into quartiles of CVD risk, those with the highest risk were more than three times as likely to develop OA as were women in the lowest-risk quartile. (See box.) Women in the two middle-risk quartiles had intermediately increased risk levels. The increase in OA episodes over the reference quartile was statistically significant for all three of the higher CVD risk quartiles.
Men also showed significantly higher rates of OA at all three of the higher CVD risk quartiles, but even in the quartile with the highest CVD risk the OA rate was just 70% above the rate among men in the lowest-risk quartile.
In three additional analyses, Dr. Kadam and his associates stratified the women by age, body mass index, or cholesterol level. A similar relationship between CVD risk and OA rate existed in younger women, but in older women the link was substantially blunted. Stratification of women their by body mass index or by their cholesterol level had no effect on the link between CVD risk and OA.
Dr. Kadam said that he and his associates had no financial relationships to disclose.
Source Elsevier Global Medical News